| NPI | 1699291328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001231) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13378) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2023-08-17 |